Eyelid Surgery
We all fear pain and have different thresholds at which we perceive pain. Your eyelids may feel tight and stinging as the anaesthesia wears off, but any associated pain after eyelid surgery or blepharoplasty is usually mild and should easily be relieved by mild analgesics.
Bruising and swelling after blepharoplasty varies from person to person-it is maximum in the first three days and usually settles over seven to fourteen days. Healing is a gradual process and your scars may remain slightly pink for six months or more. Scars vary greatly from person to person, but all go through an initial red itchy stage via a pink nodular to a leathery stage at about six to eight weeks, before fading to a thin nearly invisible white line.
There is no specific age that is best for eyelid surgery – we all age differently according to individual genetics and environmental influences – sun exposure, skin care and smoking. In my experience the more youthful look is maintained when eyelid surgery is performed on the younger patient whereas in the older patient whilst perhaps a more dramatic change is noted, deep furrows and wrinkles have already made their permanent mark and need to be accepted as they cannot be totally eradicated by surgery.
The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable and realistic about their expectations. Most are in their mid-thirties or older, but if droopy, baggy eyelids run in your family you may decide to have eyelid surgery at a younger age.
On average you can expect from six to ten years of improvement. Unfortunately the ageing process is relentless and after a period of years you will again develop ageing facial features including a recurrence of inelastic skin around the eyelids and perhaps weakened eyelid muscles-whilst usually only a minor recurrence, further improvement can be obtained by a redo of your eyelid surgery or other associated surgery such as brow lift.
Another misconception is that you may age faster once you have had eyelid surgery-this is not true and although ageing continues post surgery, it is not at an increased rate.
Facelift
If you stand in front of a mirror and lightly pull the skin up and back in the temples and in front of the ears, you will get an indication of what a facelift will achieve. The aim is a harmonious well-rested fresh look from forehead to neck whilst maintaining normal facial expression. A facelift and ancillary procedures will achieve this but not all wrinkles, furrows and folds will disappear – especially if they have been longstanding and permanent skin damage has occurred over the years.
The amount of swelling and bruising varies and is maximum in the first 3-4 days and gradually settles over the next 2-3 weeks with the blue to yellow skin staining of bruising settling in this time. Make-up is a marvellous invention and this coupled with the fact that your stitches are inconspicuously placed within your hairline and about your ears (usually easily covered with hair) will allow you to venture out usually within two to three weeks post surgery – your sutures (stitches) are all out in this time frame.
Although you will look presentable 2-3 weeks after surgery, an average healing time for skin and soft tissue is about three months. During this time your scars will go through the usual healing processes – initially appearing red and itchy, then red and lumpy, pale and lumpy, leathery and then soften to normal skin colour and texture. Individuals vary greatly in this time frame but generally improvements in results occur in a subtle way over 6-12 months.
There is no ‘best’ time in terms of age. It depends on a number of factors such as quality of skin and the nature of the problem. People often think they need a facelift, when in fact ancillary procedures, such as browlift, eyelid surgery or skin resurfacing, may be more appropriate.
A facelift doesn’t necessarily make you look younger, it makes you look better for your age. The idea is not to look too different, but rejuvenated. Although your face will age again, you always maintain the benefit of having had the procedure performed.
Browlift
The foreheadplasty operation is usually not excessively painful and mild to moderate pain relieving medication is all that is necessary. If extreme pain is felt after the operation, it may be due to bleeding under the forehead skin. This should be reported to your surgeon. Headache can be experienced post operatively. This headache rarely lasts more than 24 hours.
It is quite common for some numbness or itchiness to be present on the forehead and scalp following surgery. This could take some weeks to months for this to settle.
Most patients are able to return to work after 7-10 days.
There is no specific age that is best for a brow lift – forehead surgery. We all age differently according to our individual genetic makeup and the environmental influences of sun exposure, skin care and smoking. In my experience, the more youthful look is maintained when foreheadplasty is performed on the younger patient. In the older patient where perhaps a more dramatic change is noted, deep furrows and wrinkles have already made their permanent mark and need to be accepted as they cannot totally be eradicated by surgery.
The best candidates for forehead surgery are women and men who are physically healthy, psychologically stable and realistic about their expectations. Although there are many factors determining the overall individual result, on average you can expect six to ten years of improvement. Unfortunately, the ageing process is relentless. After a period of years you will again develop ageing forehead features with recurrence of some of the problems that you were concerned with at the initial consultation. Further improvement may be obtained by a redo of your foreheadplasty operation.
Bruising and swelling usually reach their ‘peak’ within the first 72 hours, gradually settling over the next few weeks. Bruising may drain downwards into the upper eyelids, lasting for the following 10 days. Residual swelling however, may be present for up to 6 weeks.
Nose Reshaping
We all have different thresholds at which we perceive pain, and some discomfort will be experienced with nose surgery. However, it is usually only mild to moderate and should be relieved by analgesics. Cold packs placed on the eyes and sitting in an upright position will also help minimise pain.
A “trade off’ of any surgery is some scarring. The quality and the appearance of scars varies widely with the individual’s healing process, the position of the scar on the nose, and the degree of stretching placed on the scar.
The operation can be done entirely through small incisions inside the nose, or by adding an incision across or at the base of the nostrils.
Although your surgeon will use his expertise and experience to hide and minimise any scarring, with some operations the scar, however small, will always be visible and with some areas of the body there is an unpredictable healing response of the scar.
Scars are always visible, they always take time to mature and the degree and quality of a scar can never be guaranteed.
It is important that you are aware of some of the more common side effects that can accompany your surgery, including bleeding, swelling and bruising, skin problems and headaches.
Although infrequent and unexpected, possible complications can occur, including infection, bleeding from nasal vessels, nasal obstruction, decreased sense of smell, dark circles under the eyes and allergic conditions.
Despite your surgeon’s best efforts and the best surgical care, medical literature recognises that complications do occasionally occur, despite optimal care and patient co-operation. It is most important that you take time to thoroughly read the additional information which will be provided to you about this procedure. You should also discuss with your surgeon any concerns you may have about the risks and possible side effects, including your expectations and what can and cannot be achieved.
Cosmetic surgery is real surgery and you can not expect to have nose surgery and look and feel your best overnight, as the healing process takes time.
The amount of bruising and swelling varies, but normally there will be some noticeable bruising and swelling around the eyes and cheeks for up to a fortnight. A splint will be placed on the nose for approximately eight days. You will be up and about in a couple of days and most patients return to work in a week or two. There will be some residual swelling which will not be noticeable to others and usually takes six months or more to subside. Our beauty therapist is available to help you to look as good as possible during the early post-operative period.
Ear Surgery
There is always some pain in the ears after surgery. This is usually of a throbbing nature similar to an infected or traumatised finger. If there has been a general anaesthetic the soreness is usually felt soon after you wake. However, if a local anaesthetic has been used, there will be no soreness for approximately 4 to 6 hours.
During the 8 days the bandages are on it will be a little difficult to hear normal conversation as the yellow wool dressings do go into the opening of the ear canal.
The pain and soreness usually settles in approximately 48 hours. After that time itching under the bandages is common.
We recommend wearing a bandage loosely over the ears at night for the first week after the dressings have been removed as this will help prevent any problems with rolling over and accidentally “flipping” out the new ear position.
It will be noticed that the ears are a little swollen and a little bruised even after the bandages are removed at eight days. This bruising usually settles quickly within 48 hours if it is present but the swelling can take several weeks to fully settle. It will also be noticed that the ears are quite tender if bumped and that the rim of the ear is numb. This will begin to settle after four to six weeks but will not fully settle for twelve to sixteen weeks following surgery. This is a normal consequence of the ear setback operation.
It is also advised that any contact sport be avoided for one month although non-contact sports can be engaged in approximately three weeks after surgery.